Implementation Of Nursing Process Research Articles

Exploring the Experience of Nurses on Nursing Process Implementation in Northwest Ethiopia: A Qualitative Study

Exploring the Experience of Nurses on Nursing Process Implementation in Northwest Ethiopia: A Qualitative Study

Nursing Process implementation in a gerontogeriatric context: qualitative research.

to describe Nursing Process implementation in a faith-based senior living community. strategic action research with 19 nursing professionals and three managers of a faith-based senior living community. Implementation took place in four phases: diagnosis, planning, implementation and assessment. The data collected through semi-structured interviews and focus groups were subjected to discursive textual analysis. the central categories were constructed: Nursing Process in faith-based senior living community: diagnosis of knowledge and application; Nursing Process in faith-based senior living community: implementation; Nursing process in faith-based senior living community: assessment after its implementation. Nursing Process implementation made it possible to structure work management/organization, contributing to knowledge, organization and continuity of care for safety and professional support.

THE INFLUENCE OF THE NURSES’ CHARACTERISTICS AND THE NURSES’ ATTITUDES ON THE IMPLEMENTATION OF THE NURSING CARE PLAN IN MACHAKOS COUNTY

Purpose: This descriptive cross-sectional study sought to assess the implementation of the nursing process by nurses in two sub county hospitals in Machakos county, Namely: Kangundo and Kathiani sub county hospitals. The study examined the influence of the nurses’ characteristics and the nurses’ attitudes on the implementation of the nursing process in the sub County.
 Methods: A self-administered questionnaire collected quantitative data, while key informant interviews were used to gather qualitative information. Descriptive statistics and inferential statistics (in particular, the chi-square and Fisher’s Exact) were derived from the data.
 Results: Sixty-three percent of the nurses (n=45) had drafted a NCP a week prior to the study while 35.7% (n=25) had not. Seventy-five percent of them (n=41) had implemented the NCP. The nurses who developed the nursing care plan frequently ended up implementing it (100%, n=43) compared to those who did not (23.1%, n=3; fisher’s Exact Test P=0.000). Similarly, among the nurses who did not implement the nursing process, 76.9% (N=10) of them felt that NCP is time consuming. This difference was significant at 5% confidence level (LR=8.717, df=2, p=0.013). Although statistical analysis revealed no significant association between nursing process implementation and socio-demographic factors (p>0.05), qualitative findings suggested that the newly qualified nurses are more familiar with the nursing process than their older colleagues.
 Unique contribution to theory, practice and policy: study recommends that nursing administration cultivate positive mentality among nurses towards the nursing process; particularly focusing on making nurses understand that the tool should be consistently used among all patients and that it significantly improves patient care.

Barriers to implementation of nursing process in South Gondar Zone Governmental hospitals, Ethiopia

BackgroundThe nursing process is a global concept, which forms the foundation of nursing as a profession. The use of the nursing process in most hospitals is lagging despite all the efforts of nursing professionals to implement it. The nursing process is dynamic and it is used in clinical practice worldwide to deliver quality-individualized care to patients. ObjectiveThis study assessed barriers to the implementation of the nursing process among nurses working at South Gondar Zone Governmental Hospitals, North Central Ethiopia, 2019. MethodsInstitutional based cross-sectional study was carried out. By using Census about N = 249 nurses were recruited. Data was collected through self-administered questionnaires. The data were entered into Epi data version 3.1 and analyzed using statistical package for social sciences (SPSS) version 23.0. Descriptive statistics such as measurements of central tendency and inferential statistics multiple logistic regression, 95% CI, and p-value ≤ 0.05 was used. The study was approved by Debre Tabor University college of health sciences ethics and research committee. ResultsA total of N = 249 study subjects participated with the response rate of 241 (96.4%). The mean age (SD±) of respondents' was 29.9 ± 7.2. About two-third of 146 (60%) nurses had poor knowledge of nursing process implementation. Three fourth 180 (74.7%) of nurses were implementing the nursing process. Nurses with sufficient information to NP were 2.45, nurses who have adequate skills to NP were 2.43, and nurses who have good knowledge were 2.24 times more likely to implement the nursing process than the opposite. No enough motivation to use NP 137 (56.8%), no follow-up by authority 141 (58.5%), no enough time for applying NP 145 (60.2%), no specific training for applying NP 173 (71.8%) and shortage of nurse staffs for nursing NP implementation 187 (77.6%) are also factors which affects nursing process implementation. ConclusionBased on this study only three fourth of the nurses were implementing the nursing process. For poor and non-implementation of nursing process different hindering factors were identified. Such as; shortage of time, lack of training, lack of knowledge, unrecognized by authority, no enough motivation, lack of cooperation b/n professionals, engaging in other manual tasks and unrelated tasks, unclear and poor job descriptions, work overload and poor payment for the profession were the major barriers for NP implementation. Therefore, there need to be strengthen national policy frameworks and interventions aimed at improving nursing process training and implementationin in the clinical settings.

Attitude of nursing students following the implementation of comprehensive computer-based nursing process in medical surgical internship: a quasi-experimental study

BackgroundThe nursing process is the core and the standard of practice in nursing profession. Nowadays, the use of information technology in the field of nursing processes, education and practice has been emphasized. Since nurse’s attitudes towards clinical information systems are considered as an indicator of the success rate of information systems, and nurse’s attitudes about the nursing process can affect their execution of the process. So the purpose of this study was to evaluate nursing students’ attitudes towards the nursing process software.MethodsIn this quasi-experimental study, 160 undergraduate nursing students (terms 4–8) in Tabriz University of Medical Sciences were selected by convenience sampling. To evaluate the effectiveness of nursing process software in this study, Mazlom and Rajabpoor (IJME 14(4):312–322, 2014) a questionnaire consisting of 21 components based on a five-point Likert scale was completed by students after using the software. Data were then analyzed by SPSS 19 software.ResultsThe mean score of students’ attitude toward nursing process software was high (80.70 ± 5.58). The nursing students’ highest scoring attitudes were respectively related to “Effectiveness of software in prioritizing patient care and problems”, “Completeness of patient’s electronic information compared to handwritten mode” and “Software’s effectiveness in saving your time”. The lowest scoring attitudes towards the software was respectively related to the “feeling of fairness in labor division”, “the effectiveness of the software in determining your workload” and “the feeling of satisfaction in labor division”. There was a statistically significant relationship between gender and age, and student’s attitude toward nursing process software.ConclusionsAccording to the results and analysis of nursing student’s attitudes toward nursing process software, the use of such software would be welcomed by students. It seems that changing policies in the educational and clinical substructure of nursing in order to develop, adapt and use the nursing process software is an important responsibility for nursing authorities to consider. Providing educational and clinical technology equipment, periodic evaluation of software by stakeholders and promoting the use of this software, can be fundamental steps in operationalizing the findings of this research.

Implementation and factors affecting the nursing process among nurses working in selected government hospitals in Southwest Ethiopia

BackgroundThe nursing process was initially adopted from the general system theory, and was developed and implemented in the field of education. There is a demand to implement the nursing process in practical care in every health institution, but the perception remains that it is time-consuming and impractical. If the nursing process is not valued and not used, nurses may continue to intervene on the basis of a medical diagnosis rather than on the basis of a rational nursing Process steps. In any of the steps, oversight or omission can result in less than optimal nursing care. The purpose of this study was to assess implementation and factors affecting the nursing process among nurses working in selected government hospitals in Southwest Ethiopia.MethodsAn institution-based cross-sectional descriptive study was conducted from March 10 to April 1, 2015 in three hospitals in southwest Ethiopia using self-administered questionnaires. This study included a total of 138 nurses using simple random sampling. Data were classified, coded and entered into epidemiological information version 3.5.3, and exported to the statistical package for social science version 20 for analysis, descriptive statistics were used to describe the variables, bivariable and multivariable logistic regression were used to see the effect of each variable on the dependent variable.ResultThe nursing process was found to be 73.9% implemented. Compared to a Bachelor of Science nurses’, the likelihood of implementing the nursing process was less likely among diploma nurses. Nurses working in administratively supported hospitals implemented the nursing process more compared to those without administrative support. The nursing process had been implemented higher by trained nurses compared to untrained nurses.ConclusionThe implementation of nursing process was good where; nearly seven in every ten nurses implemented the nursing process. Low educational qualification, lack of training, and non-supportive hospital administration were predictors of the nursing process implementation. The health service management, in collaboration with Ethiopian nursing/professional associations and international governmental and non-governmental organizations should give continuous on the job professional development education, and develop nursing practice guidelines.

Nursing Students’ and Teachers’ Perspectives on Clinical Education in Kuwait

Clinical education is the heart of nursing curriculum. An insight into the different perspectives could facilitate its improvement. AIMS : This descriptive, cross-sectional study aims to assess the nursing students’ and teachers’ perspectives on clinical education in Kuwait. METHODS: The study includes all faculty members of the Bachelor and Associate Degree in Nursing Programs from the College of Nursing, Kuwait (16 teachers and 12 trainers) and 120 students selected through convenient sampling from levels one to five of the Associate Degree in Nursing Program. Data were collected through self-administered questionnaire and were analyzed using the Statistical Package for Social Sciences (SPSS) version 22. Aside from descriptive statistics, T-test was utilized to compare the students’ perspectives with that of the teachers. ANOVA was used to determine any difference in the perspectives according to various factors . A significant p-value was set at less than 0.05. RESULTS: Main findings of the study illustrate six items related to the state of clinical education deemed significant by both students and teachers, namely: hospital management collaboration in resolving problems of students (p = .001); collaboration and supervision of education (p = .003); access to welfare facilities at bedside and adequacy to educational facilities at bedside with p values of .004 and .002 respectively; development of skills in nursing process implementation (p = .010) and development of patient education skills (p = .028). Factors which can potentially create problems were the lack of appropriate scientific background in the ward (p=0.047) and students wandering in the absence of instructor (p=0.025). CONCLUSION: Students’ and teachers’ perspectives on the state of clinical education in Kuwait and the factors which may potentially create problem areas have basic commonalities, focusing on the importance of collaboration between the clinical agency and the educational institution and between those actually involved in supervision of the students - the clinical staff and school faculty. RECOMMENDATION : This study recommends conducting similar studies on a wider scale, considering the technological thrusts prompted by global circumstances like the pandemic. Keywords: Nursing students; Teachers; Perspectives; Clinical Educatio DOI: 10.7176/JHMN/82-07 Publication date: November 30 th 2020

BARRIERS TO IMPLEMENTATION OF NURSING PROCESS AMONG NURSES WORKING IN NAROK COUNTY REFERRAL HOSPITAL

Purpose of the study: This study therefore assessed barriers of nursing process implementation by Narok County Referral Hospital nurses.
 Methodology: A descriptive cross sectional study design was used to collect data from 102 randomly sampled nurses in NCRH. The study instruments used were self-administered questionnaires and key informant interview. SPSS version 20.0 was used to analyze quantitative data and sample characteristics were analyzed using mean and median. Themes were used to analyze qualitative data and narratively presented. Association between the study variables was calculated using chi square at 95% level of significance while statistical significance of results obtained was calculated using p values of 0.05. Data analysis was presented using tables and graphs. Approval was sought from relevant authorities.
 Results: The study results revealed that female participants were the majority at (70.6%). Most participants (71.6%) had attained diploma level of education and among them, 92.2% had received training in nursing process. Majority 95 (93.2%) were observed not to implement nursing process and of those who implemented, only 1 (1%) correctly outlined all the steps, a sign of poor nursing process implementation. NP implementation was of statistical significance with age of nurses as 18 out of 29 of younger nurses aged 21-30 years were found to actively practice it (p =0.001, work experience (p = 0.001), training (p > 0.05): institutional factors (p = 0.001).
 Unique contribution to theory, practice and policy: Nursing process mainstreaming interventions such as regular staff refresher courses and mentorship On NP in the hospitals, availability of relevant resources: human resource and supplies can highly mitigate these barriers.

Implementation of Nursing Process and Its Association with Working Environment and Knowledge in Ethiopia: A Systematic Review and Meta-Analysis

Background The nursing process is a scientific problem-solving approach, which directs nursing care and potentially improves quality of health care service. The national pooled implementation of the nursing process in Ethiopia remains unknown. Hence, this review and meta-analysis aimed to estimate the overall implementation of the nursing process and its association with the working environment and knowledge in Ethiopia. Methods PubMed, Scopus, Cochrane Library, Google Scholar, PsycINFO, and CINAHL were searched and complemented by manual searches. The DerSimonian and Laird random effects model was applied to estimate the pooled effect size, odds ratios, and 95% confidence interval across studies. The I2 statistic was used to check heterogeneity between the studies. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. Publication bias was examined using funnel plot and Egger's regression test statistic. Analysis was performed using STATA™ Version 14 software. Results Seven studies comprised of 1,268 study participants were included in this meta-analysis. The estimated pooled implementation of the nursing process in Ethiopia was 42.44% (95% CI: 36.91, 47.97%). Based on subgroup analysis, methods of outcome measurement showed that the highest overall implementation of the nursing process was observed from studies conducted using self-report technique 42.95% (95% CI: 35.76, 50.15). Nurses working in stressful environment were 81% less likely to implement the nursing process (OR 0.19, 95% CI: 0.04, 0.76), and nurses having good knowledge were 8 times more likely to implement nursing process (OR 8.38, 95% CI: 2.82, 24.86). Conclusion The overall implementation of the nursing process in Ethiopia was relatively low. Good knowledge of nurse had paramount benefits to improve implementation of the nursing process. Therefore, nurse can be educated on the imperative of knowledge in order to enhance the nursing process implementation and to improve the overall quality of healthcare services. Furthermore, policymakers and other concerned bodies should give special attention to improving the implementation of the nursing process.

Construction and study of standardized nursing management model for hypoglycemia in diabetic inpatients

Objective To establish a standardized nursing management model for hypoglycemia in diabetic inpatients and observe its application effects. Methods Totally 9 251 diabetic patients hospitalized in People's Hospital of Zhengzhou between January and December 2017 were selected into the control group, while another 9 636 diabetic patients hospitalized in People's Hospital of Zhengzhou between January and December 2018 were selected into the observation group by cluster sampling. Patients in the control group received routine care and glycemic management. In 2018, in conjunction with the glycemic monitoring system, we established a diabetes education management team and developed a standardized nursing management process for hypoglycemia, which was promoted throughout the hospital to improve the level of hypoglycemic control among nurses throughout the hospital. Patients in the observation group received care and glycemic control using the standardized nursing management model for hypoglycemia and glycemic control. The incidence of hypoglycemia, glycemic fluctuations, and nurses' knowledge of hypoglycemia before and after implementation were compared between the two groups. Results The incidence of hypoglycemia in the observation group was lower than that in the control group [7.51% (724/9 636) vs. 18.30% (1 693/9 251) ], and the difference was statistically significant (χ2=492.7, P<0.001) . The observation group's average blood glucose value (GluAve) , daily mean amplitude of glycemic excursions (MAGE) , glycemic instability index (GLI) , and glycemic coefficient of variation (GluCV) were all lower than the control group, and the differences were statistically significant (t=-18.121, -53.788, -34.362, -61.794; P<0.01) . After the implementation of the standardized management model for hypoglycemia in 2018, the total score dimensional scores of the nurses' knowledge about hypoglycemia were higher than those before the implementation of the standardized nursing process for hypoglycemia in 2017, and the differences were all statistically (t=15.439, 66.542, 73.320, 14.565, 36.101, 34.664; P<0.01) . Conclusions The standardized nursing management model for hypoglycemia can reduce the incidence of hypoglycemia as well as fluctuations of the patients, improve the level of nurses' knowledge of hypoglycemia, and make the patients' glycemic control safer. Key words: Diabetes; Inpatient; Hypoglycemia; Nursing management

Obstacles to Nursing Process Implementation

Obstacles to Nursing Process Implementation

Determinants of the nursing process implementation in Ethiopia: A systematic review and meta-analysis, 2019

BackgroundThe nursing process is a widely known scientific method used in the nursing profession during the planning of nursing care to the patients. Its implementation plays an important role in patient diagnosis and assists personnel to increase ownership and responsibility for nursing care services delivered to patients. Despite its importance, the magnitude of national implementation remains unknown in Ethiopia. Thus, the aim of this a systematic review and meta-analysis was to pool the implementation of the nursing process in Ethiopia. MethodsThe review conducted with an extensive search of studies as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). Studies were accessed through electronic web-based search from PubMed, Google Scholar, CINAHL, EMBASE, direct Google search, and Cochrane library. The pooled estimated prevalence of nursing process implementation and its determinants were analyzed by using a random-effects model with consideration of 95% Confidence Interval (CI) in meta-analysis. ResultA total of 14 articles with 3557 studies were encompassed in this meta-analysis. The estimated pooled prevalence of nursing process implementation was 46.47%. Organized working environment [Odds ratio (OR): 2.74, with 95% (CI; 1.35, 5.56)], on-site training [OR: 2.50, with 95% CI; (1.10, 5.70)] and good knowledge of the nursing process [OR: 2.90, with 95% CI; (1.12, 7.51)] were positively associated with nursing process implementation. Conclusion and recommendationNursing process implementation showed relatively low. Health institutions should give special attention to the working environment, on-site training, and knowledge of the nurses.PROSPERO registration: CRD42019137348.

Factors Affecting Implementation of Nursing Process Among Nurses Working in Governmental Hospitals, Oromia Region, Ethiopia, 2016: Cross Sectional Study

<i>Background</i>: Nursing process used in clinical practice worldwide to deliver quality individualized care to patients and lack of its application can reduce the quality of care. Nursing Process is a systematic problem-solving approach used to identify, prevent and treat actual or potential health problems and promote wellness. It has five steps- assessment, diagnosis, planning, implementation, and evaluation. Applying nursing process requires understanding of factors affecting its implementation from the perspective of nurses. Nursing process implementation could be highly influenced by different factors that can lead to poor quality of nursing care, disorganization of the service, conflicting roles, medication error, poor diseases prognosis, readmission, dissatisfaction with the care provided, and increased mortality. These problems are manageable if a nurse can properly implement nursing process. <i>Objective</i>: The main aim of this study was to assess factors affecting implementation of nursing process among nurses in governmental hospitals of Arsi Zone. <i>Materials and Methods</i>: A cross-sectional study was used to conduct on governmental hospitals in Arsi Zone from December- June 2016. Both quantitative and qualitative methods were used. All governmental hospitals in Arsi Zone was used since they were convenient for the study. Numbers of the participants were small, so all those who full fill inclusion criteria were participant in the study. Tools were given to nurse out of the study to check for its validity and adjustment was made according to the feedback obtained before actual data collection. Data was collected using self-administered questionnaire and in-depth interview. Data was analyzed using SPSS 21.0 version. <i>Result</i>: Findings revealed that organizational factors have the highest predictive value in the use of nursing process, followed by practice related factors. <i>Conclusion and Recommendation</i>: The result concluded that the organizational factors have the most important influence on the use of nursing process. It is recommended that the organization should fulfill needed materials which are necessary to provide nursing care. This will enhance nurses’ ability to use nursing process to improve the quality of patient’s care.

Implementation Status of Nursing Process and Associated Factors AmongNurses Working in Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia, 2017

Background: -Nursing process is a systematic method of assessing, diagnosing, planning, intervening and evaluating individualized care for clients in any state of health. Even if, its implementation is mandatory due to many factors, it is poorly implemented in most of the health institutions in the country and resulted loss of quality nursing care. Objective:-The aim of this study was to assess the implementation status of nursing process and its’ associated factors among nurses in Tikur Anbessa Specialized Hospitals. Method: -A cross-sectional study design was conducted from February to March 2017 with a total of 151 participants and 271 medical records were selected by using Simple random sampling method. The collected datachecked for accuracy, completeness and entered into epi- data version 3.1 and analyzed using SPSS version 22. Bivariate and multivariate logistic regressions were used to identify associated factors with nursing process implementation. Statistical significance interpreted using odds ratio with 95% CI & P value <0.05. Result: - A total of 151 respondents, mean age was 28.5 years and about 86 (57.6%) had implement nursing process. Working in medical ward unit [AOR=3.43, (1.01, 11. 5), surgical unit [AOR=9.59(2.21, 41.61), organized environment [AOR=4.44 (1.80, 10.95) and Good Knowledge [AOR=10.2, (3.05, 34.1) were significantly associated with the implementation of 271 medical card review 239 of the cards included nursing process registration form, amongthose 65 (24.6%) of them was found to include the nursing process and those staying in the hospital for 11-20 days and 21-30 days was [AOR= 1.8895 (1.01, 3.53) and AOR=2.84 (1.06, 7.5) were significantly associated with implementation of the nursing process. Conclusion and recommendation: In this studythe level of nursing Process implementation was suboptimal and it needs further intervention to increase its utilization. Those who had worked at medical and surgical unit, organized work environment, good knowledge and length of stay were identified as possible determinant factors for the implementation of nursing process. Health care authorities must help in promotion of the health care with employing sufficient nurses, educational training and providing necessary situations for nursing process.

The Effectiveness of Nursing Process Implementation with Concept Mapping via Mobile Phone on Nursing Student Self-Efficacy in Critical Care Course

The Effectiveness of Nursing Process Implementation with Concept Mapping via Mobile Phone on Nursing Student Self-Efficacy in Critical Care Course

Determinants of Nursing Process Implementation in North East Ethiopia: Cross-Sectional Study.

Nursing process is a framework used to provide an effective, coordinated, and organized quality care for patients. Effective implementation of this framework leads to improved quality of care and decreases potential complication, hospital length of stay, and the cost of care. To assess implementation of nursing process and its hindering factors, a quantitative cross-sectional study was conducted among nurses in Afar region hospitals from October 2016 to December 2016. The data were collected from 102 nurses using primary Brooking's ward nurses' self-report questionnaire and with some newly prepared questions. The collected data were entered using Epi-Data version 3.1 and analyzed by SPSS version 20 and then presented by tables, graphs, and figures. Forty-three (42.1%) nurses were implementing nursing process at the time of data collection. Assessment and diagnosis were carried out by 57 (56.9%) nurses, planning by 46% of nurses, implementation by 38.2% of nurses, and evaluation by 36.2% of nurses in Afar region. Among the hindering factors towards nursing process implementation, lack of preparedness or knowledge about the nursing process or some part of it (83.3%) and absence of in-service training pertinent to nursing process (75.5%) were the most mentioned ones. Generally, nursing process was poorly implemented in Afar region mainly due to lack of knowledge and absence of in service training. Therefore, giving emphasis for cognitive parts of students about nursing process during their school time and refreshing nurse staffs with continuous training will definitively improve level of nursing process implementation.

A cross sectional study on nursing process implementation and associated factors among nurses working in selected hospitals of Central and Northwest zones, Tigray Region, Ethiopia

BackgroundThe nursing process is a systematic method of planning, delivering, and evaluating individualized care for clients in any state of health or illness. Many countries have adopted the nursing process as the standard of care to guide nursing practice; however, the problem is its implementation. If nurses fail to carry out the necessary nursing care through the nursing process; the effectiveness of patient progress may be compromised and can lead to preventable adverse events. This study was aimed to assess the implementation of nursing process and associated factors among nurses working in selected hospitals of central and northwest zones of Tigray, Ethiopia, 2015.MethodA cross sectional observational study design was utilized. Data was collected from 200 participants using structured self-administered questionnaire which was contextually adapted from standardized, reliable and validated measures. The data were entered using Epi Info version 7 and analyzed using SPSS version 20 software. Data were summarized and described using descriptive statistics and multivariate logistic regression was used to determine the relationship of independent and dependent variable. Then, finally, data were presented in tables, graphs, frequency percentage of different variables.ResultSeventy (35%) of participants have implemented nursing process. Different factors showed significant association. Nurses who worked in a stressful atmosphere of the workplace were 99% less likely to implement the nursing process than nurses who worked at a very good atmosphere. The nurses with an educational level of BSc. Degree were 6.972 times more likely to implement the nursing process than those who were diploma qualified. Nurses with no consistent material supply to use the nursing process were 95.1% less likely to implement the nursing process than nurses with consistent material supply.ConclusionThe majority of the participants were not implementing the nursing process properly. There are many factors that hinder them from applying the nursing process of which level of education, knowledge of nurses, skill of nurses, atmosphere of the work place, shortage of material supply to use the nursing process and high number of patient load were scientifically significant for the association test.

Condition of clinical handover for critical patients: a literature review

The clinical handover, which is associated with the observation of the changes in patients′ status and the implementation of nursing process, plays a vital role in critical care. Also, the quality of clinical hand-over has a far-reaching impact on patient safety due to the complicate condition of critical patients. Over the past few years, lots of studies have focused on the many aspects of clinical handover such as the contents of clinical handover, the standard procedure of clinical handover so as to reduce the risks associated with the unsystematic clinical handover. Key words: Critical patients; Clinical handover; Patient safety; Critical care

Returning Nursing to Nightingale: The Bigger Picture of Mainstreaming Kenya-Nursing Process

Application of all Nursing Process steps as a standard practice in nursing at national scale is a very rare occurrence in clinical practice and in nursing literature. This paper presents lessons learnt in the bigger picture of mainstreaming Nursing Process within a public sector context at national level covering issues on policy, financing, training, implementation (practice and management) and effects. It discusses Nursing Process in context; structuring discussion in a way integrating nursing theories, facilitating professional empowerment, ensuring higher quality nursing care, and nursing visibility and contributions in healthcare delivery. Based on practical experience in integrating Virginia Henderson’s need theory, Orem’s health systems theory, total nursing care and team nursing within Nursing Process, it suggests replacement of medical model paradigm with caring model paradigm to facilitate effective independence and meaningful dependence and interdependence in nursing operations. Thus significant organizational cultural shift is proposed. Nursing Process is presented as the principal vehicle propelling nursing profession and practices forward, sampling success stories that demonstrate effectiveness and improved patient care. On standardization of nursing language, new innovative ideas under Nursing Process steps of assessment, diagnosis, planning and documentation are presented with suggestions of a new approach in measuring Nursing Process implementation using Benner’s “stages of clinical competence” scale, focusing on levels of knowledge and skills in Nursing Process. In that thinking Nursing Process implementation is likely to succeed through challenges, especially when competency level is reached and surpassed; notwithstanding exogenous challenges such as restructuring in a health system or a political system that bear influence on nursing operations. It is proposed that nurturing Nursing Process implementation through training to competency level within the premise of “totality of knowledge and experience” is critical in achieving reasonable nursing visibility in clinical settings, enhancing quality nursing care, and ensuring sustainability through the principle of critical mass. Thus a significant shift from developing individual nurses in single bits to collective development of a nursing workforce in Nursing Process must be made, availing a committed and cohesive critical mass of nurses working towards achieving desired professional and organizational goals despite challenges; promoting Nursing Process practices to the level of organizational culture in healthcare delivery. This requires time, resources, commitment and above all, strong and focused leaderships in nursing. The article is in four parts. Part 1 discusses contextual information critical in understanding the Kenya Nursing Process and its context. Part 2 discusses detailed explanation and practical understanding on the six Kenya Nursing Process steps. Part 3 discusses the theoretical frameworks critical in mainstreaming activity. Part 4 discusses outcomes, challenges, and concerns. It also includes way forward and conclusions.

Developing a social media platform for nurses.

Social media tools provide opportunities for nurses to connect with colleagues and patients and to advance personally and professionally. This article describes the process of developing an innovative social media platform at a large, multi-centre teaching hospital, The Ottawa Hospital, Canada, and its benefits for nurses. The platform, TOH Nurses, was developed using a nursing process approach, involving assessment, planning, implementation and evaluation. The aim of this initiative was to address the barriers to communication inherent in the large number of nurses employed by the organisation, the physical size of the multi-centre hospital and the shift-work nature of nursing. The platform was used to provide educational materials for clinical nurses, and to share information about professional practice. The implications of using a social media platform in a healthcare setting were considered carefully during its development and implementation, including concerns regarding privacy and confidentiality.